The day your menstrual cycle begins you should call the clinic’s office to let them know. Commencing on day 3 of the cycle, the female patient will come to the doctor's office between 7:00 a.m. and 8:30a.m. Day 1 is considered the first day that your menstrual flow is constant, not light spotting. When your period starts, please call the office and leave a message on our voice mail.
On your day 3 appointment, you will have a baseline ultrasound performed (a full bladder is mandatory) and your fertility medication injections will start or if you are taking Clomiphene Citrate, Letrozole, or other medication you will start taking it on this day. Ultrasound is performed from time to time throughout the cycle monitoring phase to confirm maturation of follicles in the ovaries.
With regards to the hormone blood testing, we are measuring the estradiol (estrogen) and LH (luteinizing hormone) which rises (surges) prior to ovulation. When the ultrasound and blood work have confirmed that you are ready for ovulation, a single injection of hCG is given intra-muscularly to trigger ovulation. At this time you will either be given instructions for intercourse, or insemination will take place the next two mornings.
Progesterone suppositories will then be used, one in the morning and one at night, starting the morning after the second insemination or 3 days after the hCG injection. These continue until pregnancy test is performed on day 28. You will return day 21 of the cycle for a blood test to measure progesterone level. You will return day 28 of the cycle for a pregnancy test by blood.